Abstract P6-08-12: Toward Comprehensive Cancer Prevention for Women Experiencing Homelessness: Demonstrating the Need for Onsite Mammography, Education, Navigation, and Cross Cancer Screenings
Authors: Pamela Combs, Heather M. Hurwitz, Markayla Mariner, NaSheema Anderson, Kate Mccaffrey, Raymond Jackson, Sarah Kilic, Tiffany Onger, Kimberly Sanders, Tyler Stimpert, Jeremy Suwarna, Jeremy Weleff, Chirag Shah
Journal: Cancer Research (2023)

Abstract Background: Persons experiencing homelessness (PEH) rarely receive regular preventative health care or consistent cancer screenings. Late stage detection of cancer and barriers to care are prevalent among PEH. Novel programs such as onsite mobile mammography services represents an approach to improve breast cancer disparities among women experiencing homelessness (WEH) and allows for understanding of barriers to cancer screening amongst WEH and to develop best practices. Objectives: During onsite mobile mammography events at shelters for WEH, develop best practices for improving breast cancer screening utilization while developing approaches to increase use of other cancer screenings. Methods: In 2022, the Cleveland Clinic performed onsite mobile mammography screening events at area shelters and day centers. All seven screening events included onsite mammography, breast health education, and patient navigation. After WEH completed the education session, they completed the mammogram. Subsequently, at two events, patients had an opportunity for further consultation with an advanced practice provider (APP) including discussing additional screening tests (ex. colorectal, lung, cervical cancer) beyond mammograms with referrals as needed. Consultations also discussed approaches to reduce cancer risks with further education, referrals for dental care, and assistance securing a primary care provider (PCP). Results: At the events that included consultations, 30 patients received mammograms and 80% (n=24) of patients chose to speak with the APP. Patients seeking consultation were 21-73 years old and identified as Black/African American (n=5), White (n=16), and other (n=3). Topics of discussion included mammograms (n=24, 100%), smoking cessation referral and/or lung cancer screening (n=16, 67%), colorectal cancer screening (n=11, 46%), and cervical cancer/HPV screening (n=11, 46%). Additionally, 46% of patients (n=11) were assisted with securing a PCP and 8% of patients (n=2) were referred for dental services. Discussion: Our preliminary data demonstrate that most WEH undergoing onsite mammography screening are willing to engage in consultation to discuss additional cancer screenings with many patients eligible for additional cancer screenings. Additionally, this approach provided access to PCPs. Three best practices for cross cancer screenings include: 1) Onsite mobile mammography is an appropriate entry point for addressing breast health and also cancer screening broadly. 2) An onsite approach allows for education beyond cancer screening to provide access to primary care and other wrap around services. 3) Clinicians provide credibility and trust when they attend onsite mobile mammography events. Conclusion: Beyond breast cancer screening, WEH benefit from onsite mobile mammography, which can serve as a gateway to cross cancer screenings and access to primary care. Addressing disparities in this population should include wrap around services such as smoking cessation and connection to a PCP. Future research should examine best practices for following up with patients and completing navigation through cross cancer screenings. Citation Format: Pamela Combs, Heather M. Hurwitz, Markayla Mariner, NaSheema Anderson, Kate Mccaffrey, Raymond Jackson, Sarah Kilic, Tiffany Onger, Kimberly Sanders, Tyler Stimpert, Jeremy Suwarna, Jeremy Weleff, Chirag Shah. Toward Comprehensive Cancer Prevention for Women Experiencing Homelessness: Demonstrating the Need for Onsite Mammography, Education, Navigation, and Cross Cancer Screenings [abstract]. In: Proceedings of the 2022 San Antonio Breast Cancer Symposium; 2022 Dec 6-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2023;83(5 Suppl):Abstract nr P6-08-12.